Prescription Costs

Passport1

Passport1

Joined
Sep 17, 2012
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Location
A Barrier Island
I take several Rxs for chronic but not serious issues. My wife takes several more. We pay only a small copay for which I am thankful. I like to check locally to see if our Walgreens has the best prices. I am astounded at the retail cost of most of these drugs. Some of the capsules are easily >$3 each.

For those of you on maintanence meds what do your costs look like? Are there regional differences?
 
You can buy some prescriptions for as little as 1/3 the price of buying them in the US. Made by the same company no less. These foreign purchases are not being sold to you at a loss!
 
I'm on various psych meds, and have been for years. Always paid $10/month for generics and $30/month for name brand. Kaiser pharmacy.
 
My grandmother needed to take Lyrica (pregabalin) for debilitating nerve pain in her face starting in her early 80s. The prescription was around $1300 a month in 2006. Medicare and her (very expensive) supplemental insurance wouldn't pay a dime.
 
Passport1 said:
For those of you on maintanence meds what do your costs look like?
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Without going into details - this isn't hearsay - I know of a medication that's $15,000 (monthly). This is for (180) tablets, taken (6) per day.

Passport1 said:
Are there regional differences?
Click to expand...
Outside of the US ? Sure. In the US ? Nope, everyone pays the same as it's dictated by insurance companies in most cases, at least when it's a medication they cover. Some insurance companies pay different amounts for different medications but overall, it's a wash.
 
I feel free market SHOULD rule in just about everything. However, when it comes to meds, sometimes there should be some intervention. One law that I feel should be passed is that medicine sold in the U.S. should cost no more of the price as what it sells for in other countries. You see the same medication sold for cheaper prices to the south and to the north of us, as well as the costs of it in other parts of the world. As posted, the medicine manufacturers are not losing money by selling it there. As far as the comments of knowing some medication that costs $15K per month, just for giggles, whenever you see some sort of medication being advertised on TV, just do a Google search on the cost of that medication. I've seen plenty that goes for more than $25K.
Remember when the TV was plagued with name-brand ED medicines? Obviously, the patents have run out, because I haven't seen a commercial on those meds for quite some time.
 
Unpacking the way prescription drugs are priced in the US to the consumer is complex, and there are a variety of reasons consumers pay different prices or have a different perception of the cost of the medicine. The following is a limited list of rambling about what could impact prices.

We have a hodgepodge of ways medical and therefore prescription drugs are priced to the consumer. Commercial insurance varies between copay and coinsurance. The advent of high deductible health plan passes additional cost along to consumers at the benefit of a lower premium as well as saving vehicles like HSAs. Among medicare health plans have different incentives if they manage all medical costs versus medical and pharmacy costs (MAPD versus PDP plans). Medicaid is run at a state level and may have different incentives if the state is organized as a FFS state or not, how or who negotiates prices for the state, etc. The list goes on. Branded drugs are often rebated back to health plans, those savings may or (more often) may not be passed directly to the end consumer because insurance is a risk pooling vehicle. Health plans may get more money for drug X if they block coverage of drug y for people that utilize their coverage. If a consumer then gets drug y, they may pay full cost. Prescription drugs costs are subject to mandatory inflationary rebates among a variety of channels (commercial, medicare, medicaid), which pass different costs to consumers in each bucket. Manufacturers can offer direct to consumer copay cards to offset costs of some drugs - in turn health plans may take steps to aggregate these types of programs and have them not count towards a patient deductible. Specialty pharmacies negotiate discounts and may be incentivized based on volume for a certain product. Health plans and pharmacy benefit managers negotiate pricing of drugs with pharmacies too, theres a whole level I have not even addressed yet as I ramble. The advent of things like GoodRx brings another entity to negotiate net prices and take their cut of discounts on drugs. New drugs are often commercialized in the western market first, and single payer systems that are willing to pay less often don't have a product commercialized as quickly or in some cases ever.

The above literally only scratches the surface or the reasons costs may be high or different people can walk up to the pharmacy counter and pay wildly different prices for medicines.
 
Kruse said:
the medicine manufacturers are not losing money by selling it there
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Just playing devil's advocate, one argument is they do lose money in those countries but make it up with sales in the US.

Kruse said:
the comments of knowing some medication that costs $15K per month, just for giggles, whenever you see some sort of medication being advertised on TV
Click to expand...
The one I'm referring to isn't advertised on TV.
 
I pay full cost for Rx's until the deductible is met for our high deductible health care plan. Any long term prescriptions have to be through a mail order outfit which my employer keeps changing every 1-3yrs. Currently through Costco. Luckily the scrips my wife and i take are super inexpensive for 90 day supplies.

I have had to turn down many meds for my psoriasis. Some topical stuff is $1200+ per small tube. The oral meds for it, forget it.
 
Kruse said:
I feel free market SHOULD rule in just about everything. However, when it comes to meds, sometimes there should be some intervention. One law that I feel should be passed is that medicine sold in the U.S. should cost no more of the price as what it sells for in other countries. You see the same medication sold for cheaper prices to the south and to the north of us, as well as the costs of it in other parts of the world. As posted, the medicine manufacturers are not losing money by selling it there. As far as the comments of knowing some medication that costs $15K per month, just for giggles, whenever you see some sort of medication being advertised on TV, just do a Google search on the cost of that medication. I've seen plenty that goes for more than $25K.
Remember when the TV was plagued with name-brand ED medicines? Obviously, the patents have run out, because I haven't seen a commercial on those meds for quite some time.
Click to expand...
My company is working on a new drug. It might cost upwards of $1M per dose. But it cures a horrible disease. And you only need one dose.

We negotiate the cost of our approved drugs with each country. There is a lot of politics involved. We had one European country set our pricing a lot less than other countries. Since EU has something similar to your idea of not selling for more than in another country, we withdrew our application from the low-balling country.
 
Leo99 said:
My company is working on a new drug. It might cost upwards of $1M per dose. But it cures a horrible disease. And you only need one dose.

We negotiate the cost of our approved drugs with each country. There is a lot of politics involved. We had one European country set our pricing a lot less than other countries. Since EU has something similar to your idea of not selling for more than in another country, we withdrew our application from the low-balling country.
Click to expand...
IRP a.k.a. international reference pricing. Part of any new drugs launch planning for Pharma companies.
 
In Vancouver we pay through the ass for gasoline but I haven't paid for a single prescription, medical procedure, or therapy of any kind in more than 25 years.

It's looked after through the benefits package at work.
 
Hall said:
Without going into details - this isn't hearsay - I know of a medication that's $15,000 (monthly). This is for (180) tablets, taken (6) per day.


Outside of the US ? Sure. In the US ? Nope, everyone pays the same as it's dictated by insurance companies in most cases, at least when it's a medication they cover. Some insurance companies pay different amounts for different medications but overall, it's a wash.
Click to expand...

Oversimplified. Manufacturers often give "coupons" to a pharmacy and exclude others in the same geo region. Everyone paying the same isn't accurate. I'm a guy who doesn't even take aspirin and try not to take anything. But I do need a lower dose of BP meds. Thank you family!! :ROFLMAO: Local CVS is absurd at $60 month; small business pharmacy $30 a month and (drumroll)......pharmacy a state away mail order is $30 for 3 months supply. Reason is the maker has chosen them to be a premier supplier and they get the coupons.

They all play games....and for me I'm grateful as it was my Dr. she's awesome and HOT! who found the mailorder place. She knows us old cops are cranky and cheap! It's not often talked about but there are few if any entities in the world that carry more political and financial power.
 
My son works for a well known pharmaceutical company. He often has to supply clinics with sample products. The cost of those is staggering. The patients get put on one or another for free then they are stuck when they have to get the Rx renewed.

That's a bit of a stretch from 'free market'.
 
Leo99 said:
My company is working on a new drug. It might cost upwards of $1M per dose. But it cures a horrible disease. And you only need one dose.

We negotiate the cost of our approved drugs with each country. There is a lot of politics involved. We had one European country set our pricing a lot less than other countries. Since EU has something similar to your idea of not selling for more than in another country, we withdrew our application from the low-balling country.
Click to expand...

I'm guessing HIV. They have a cure for Hep C now.
 
BISCUT said:
Local CVS is absurd at $60 month; small business pharmacy $30 a month
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Price differences between CVS and a local pharmacy isn't a "regional" thing, it's CVS' pricing decision. I would bet that the price of drug "X" at Walgreens in New York state will be the same as a Walgreens in Texas or Oregon or wherever.

BISCUT said:
They all play games....
Click to expand...
Yeap and if there's one place I sometimes think gov't intervention was necessary, it's medical care and drug pricing. Back to price differences, using GoodRX (which basically finds "coupons" that work with different pharmacies), here's an example:

Meijer - $2.50 (they are a Walmart-type chain in the midwest)
Sam's Club - $5.00
Rite Aid - $6.10
Kroger - $14.45
Walgreens - $14.99
Walmart - $15.00
CVS - $29.58
Target - $29.58
 
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